| NPI | 1861458291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030830) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052409) |
| 363A00000X Physician Assistant (Licence: MD C03249) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-01-19 |